Friday, January 22, 2010

Am Anfang

Before class today I popped up to the 12th floor library and checked out a book that At Your Cervix recommended, Midwifery and Childbirth in America by Judith Pence Rooks. I'm a little nervous about my first birth-related book. I have a bad habit of obsessing over a topic, then checking out a stack of books and never reading any of them - losing interest because the effort involved in continuing to learn is too great. I'll keep you updated on progress.

In other news, class was fun. This was the session I'd sat in on last semester, so the material was familiar. We covered the Health Belief Model and the Theory of Reasoned Action, both in much simpler form than Wikipedia presents. The professor is making the argument that most public health interventions are based on these or similar models, which are inaccurate representations of human behavior. One of the texts for the class is Dan Ariely's Predictably Irrational, which I read after sitting in last semester. I am definitely willing to buy that we should stop depending on human behavior to be rational. What I haven't heard yet is an example of a successful intervention based on a model that takes this into account.

It also occurred to me to wonder if you get better results from these models for health behaviors that are less dependent on broad issues (socioeconomics, social inequity, lack of access, etc.). The only example I can think of at the moment is hand-washing, say in the US, so we can assume the presence of clean water, bathrooms with soap in public places, and so forth. Also assume with me for the moment that hand-washing habits are not greatly shaped by fundamental, underlying factors like those mentioned above. Can you motivate people to adopt better hand-washing habits using one of the models above? Is it that the models just completely don't capture behavior-related decision making, or is it that behavior-related decision making is usually so much more complicated and tied to all these other things?